Extended Care Add-On Request

UEC Programs

0

Extended Care Add-On

"*" indicates required fields

Camper's Name*

First Last

Parent's Email*

Enter Email Confirm Email

Parent's Phone*

Add-On selection will be added to your invoice and is due with weekly tuition

Session to Add On

Session 1 ~ June 15-19

Session 2 ~ June 22-26

Session 3 ~ June 29-July 4

Session 4 ~ July 6-10

Session 5 ~ July 13-17

Session 6 ~ July 20-24

Session 7 ~ July 27-31

Session 8 ~ August 3-7

Care Needed ~ Week 1*

Week 1 added to Invoice

Before Care ~ 7:30am

After Care ~ 4:00-6:00pm

Before Care & After Care ~ 7:30am & 4:00-6:00pm

This field is hidden when viewing the form

Extended Care Needed ~ Week 1*

Week 1 due with submission (Processing Fees Included)

Before Care ONLY ~ 7:30am

After Care ONLY ~ 4:00-6:00pm

Before & After Care ~ 7:30am & 4:00-6:00pm

Extended Care Needed ~ Week 2*

Week 2 added to Invoice

Before Care ~ 7:30am

After Care ~ 4:00-6:00pm

Before Care & After Care ~ 7:30am & 4:00-6:00pm

This field is hidden when viewing the form

Extended Care Needed ~ Week 2*

Week 2 due with submission (Processing Fees Included)

Before Care ONLY ~ 7:30am

After Care ONLY ~ 4:00-6:00pm

Before & After Care ~ 7:30am & 4:00-6:00pm

Extended Care Needed ~ Week 3*

Week 3 added to Invoice

Before Care ~ 7:30am

After Care ~ 4:00-6:00pm

Before Care & After Care ~ 7:30am & 4:00-6:00pm

This field is hidden when viewing the form

Extended Care Needed ~ Week 3*

Week 3 due with submission (Processing Fees Included)

Before Care ONLY ~ 7:30am

After Care ONLY ~ 4:00-6:00pm

Before & After Care ~ 7:30am & 4:00-6:00pm

Extended Care Needed ~ Week 4*

Week 4 added to Invoice

Before Care ~ 7:30am

After Care ~ 4:00-6:00pm

Before Care & After Care ~ 7:30am & 4:00-6:00pm

This field is hidden when viewing the form

Extended Care Needed ~ Week 4*

Week 4 due with submission (Processing Fees Included)

Before Care ONLY ~ 7:30am

After Care ONLY ~ 4:00-6:00pm

Before & After Care ~ 7:30am & 4:00-6:00pm

Extended Care Needed ~ Week 5*

Week 5 added to Invoice

Before Care ~ 7:30am

After Care ~ 4:00-6:00pm

Before Care & After Care ~ 7:30am & 4:00-6:00pm

This field is hidden when viewing the form

Extended Care Needed ~ Week 5*

Week 5 due with submission (Processing Fees Included)

Before Care ONLY ~ 7:30am

After Care ONLY ~ 4:00-6:00pm

Before & After Care ~ 7:30am & 4:00-6:00pm

Extended Care Needed ~ Week 6*

Week 6 added to Invoice

Before Care ~ 7:30am

After Care ~ 4:00-6:00pm

Before Care & After Care ~ 7:30am & 4:00-6:00pm

This field is hidden when viewing the form

Extended Care Needed ~ Week 6*

Week 6 due with submission (Processing Fees Included)

Before Care ONLY ~ 7:30am

After Care ONLY ~ 4:00-6:00pm

Before & After Care ~ 7:30am & 4:00-6:00pm

Extended Care Needed ~ Week 7*

Week 7 added to Invoice

Before Care ~ 7:30am

After Care ~ 4:00-6:00pm

Before Care & After Care ~ 7:30am & 4:00-6:00pm

This field is hidden when viewing the form

Extended Care Needed ~ Week 7*

Week 7 due with submission (Processing Fees Included)

Before Care ONLY ~ 7:30am

After Care ONLY ~ 4:00-6:00pm

Before & After Care ~ 7:30am & 4:00-6:00pm

Extended Care Needed ~ Week 8*

Week 8 added to Invoice

Before Care ~ 7:30am

After Care ~ 4:00-6:00pm

Before Care & After Care ~ 7:30am & 4:00-6:00pm

This field is hidden when viewing the form

Extended Care Needed ~ Week 8*

Week 8 due with submission (Processing Fees Included)

Before Care ONLY ~ 7:30am

After Care ONLY ~ 4:00-6:00pm

Before & After Care ~ 7:30am & 4:00-6:00pm

Total

Payment Method

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name